中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2013年
13期
1928-1930
,共3页
颈动脉疾病%脑血管意外%氟伐他汀%阿司匹林
頸動脈疾病%腦血管意外%氟伐他汀%阿司匹林
경동맥질병%뇌혈관의외%불벌타정%아사필림
Carotid artery diseases%Cerebrovascular accident%Fluvastatin%Aspirin
目的 观察通过大样本研究拟对神经内科脑卒中合并颈动脉粥样硬化斑块患者进行强化降脂治疗改善脑卒中预后及降低复发率的研究.方法 将入选300例脑梗死合并存在不同程度颈部斑块者患者随机分成三组,各100例.强化降脂组给予氟伐他汀80 mg/d+阿司匹林100 mg；常规剂量组给予氟伐他汀40 mg/d+阿司匹林100 mg；阿司匹林组给予阿司匹林100 mg.观察:用药第4周、8周、12周、16周、20周、24周血脂水平、颈内动脉斑块变化(CIMT)、斑块面积、用药24周中脑血管事件再发生率.结果 强化降脂组治疗后IMT(1.06±0.36) mm、斑块面积(8.09±0.47)mm3、用药24周中脑血管事件再发生率(12％)、血脂水平和常规剂量组治疗后IMT(1.19±0.39) mm、斑块面积(9.91±0.78)mm3、用药24周中脑血管事件再发生率(18％)、血脂水平后较阿司匹林组明显降低(均P＜0.05)；阿司匹林组治疗前后IMF、斑块面积及血脂水平差异无统计学意义(P＞0.05)；强化降脂组治疗后较常规剂量组IMT、斑块面积及血脂水平改善更明显(P＜0.05),与另外两组比较缺血性脑血管病复发率差异有统计学意义(P＜0.05).结论 强化降脂治疗降血脂水平、延缓和逆转颈动脉粥样硬化优于使用予氟伐他汀常规剂量及单纯抗血小板治疗,并可预防缺血性脑血管病复发.
目的 觀察通過大樣本研究擬對神經內科腦卒中閤併頸動脈粥樣硬化斑塊患者進行彊化降脂治療改善腦卒中預後及降低複髮率的研究.方法 將入選300例腦梗死閤併存在不同程度頸部斑塊者患者隨機分成三組,各100例.彊化降脂組給予氟伐他汀80 mg/d+阿司匹林100 mg；常規劑量組給予氟伐他汀40 mg/d+阿司匹林100 mg；阿司匹林組給予阿司匹林100 mg.觀察:用藥第4週、8週、12週、16週、20週、24週血脂水平、頸內動脈斑塊變化(CIMT)、斑塊麵積、用藥24週中腦血管事件再髮生率.結果 彊化降脂組治療後IMT(1.06±0.36) mm、斑塊麵積(8.09±0.47)mm3、用藥24週中腦血管事件再髮生率(12％)、血脂水平和常規劑量組治療後IMT(1.19±0.39) mm、斑塊麵積(9.91±0.78)mm3、用藥24週中腦血管事件再髮生率(18％)、血脂水平後較阿司匹林組明顯降低(均P＜0.05)；阿司匹林組治療前後IMF、斑塊麵積及血脂水平差異無統計學意義(P＞0.05)；彊化降脂組治療後較常規劑量組IMT、斑塊麵積及血脂水平改善更明顯(P＜0.05),與另外兩組比較缺血性腦血管病複髮率差異有統計學意義(P＜0.05).結論 彊化降脂治療降血脂水平、延緩和逆轉頸動脈粥樣硬化優于使用予氟伐他汀常規劑量及單純抗血小闆治療,併可預防缺血性腦血管病複髮.
목적 관찰통과대양본연구의대신경내과뇌졸중합병경동맥죽양경화반괴환자진행강화강지치료개선뇌졸중예후급강저복발솔적연구.방법 장입선300례뇌경사합병존재불동정도경부반괴자환자수궤분성삼조,각100례.강화강지조급여불벌타정80 mg/d+아사필림100 mg；상규제량조급여불벌타정40 mg/d+아사필림100 mg；아사필림조급여아사필림100 mg.관찰:용약제4주、8주、12주、16주、20주、24주혈지수평、경내동맥반괴변화(CIMT)、반괴면적、용약24주중뇌혈관사건재발생솔.결과 강화강지조치료후IMT(1.06±0.36) mm、반괴면적(8.09±0.47)mm3、용약24주중뇌혈관사건재발생솔(12％)、혈지수평화상규제량조치료후IMT(1.19±0.39) mm、반괴면적(9.91±0.78)mm3、용약24주중뇌혈관사건재발생솔(18％)、혈지수평후교아사필림조명현강저(균P＜0.05)；아사필림조치료전후IMF、반괴면적급혈지수평차이무통계학의의(P＞0.05)；강화강지조치료후교상규제량조IMT、반괴면적급혈지수평개선경명현(P＜0.05),여령외량조비교결혈성뇌혈관병복발솔차이유통계학의의(P＜0.05).결론 강화강지치료강혈지수평、연완화역전경동맥죽양경화우우사용여불벌타정상규제량급단순항혈소판치료,병가예방결혈성뇌혈관병복발.
Objective To observe cerebral apoplexy patients complicated with carotid atherosclerosis plaque given aggressive lipid lowering treatment on the prognosis of stroke and reduce the recurrence rate through the large sample study on neurological department of internal medicine.Methods 300 cases of cerebral infarction complicated with different degree of neck lesions were selected and randomly divided into 3 groups,each group had 100 cases.Intensive lipid-lowering group received fluvastatin,80mg/d + 100mg aspirin,conventional dose group received fluvastatin,40mg/d + 100mg aspirin,aspirin group was given aspirin 100mg.After 4 weeks,8 weeks,12 weeks,16 weeks,20 weeks,24 weeks,blood lipid level,changes in internal carotid artery plaque (CIMT),plaque area,and the incidence rate of cerebral vascular events after 24 weeks were observed.Results The results of intensive lipid-lowering treatment group IMT (1.06 ± 0.36) mm,plaque area (8.09 ± 0.47) mm3,the incidence rate of cerebral vascular events after 24 weeks (12％),serum lipid levels and regular dose group after treatment with IMT (1.19 ±0.39) mm,plaque area (9.91 ± 0.78) mm3,the incidence rate of cerebral vascular events after 24 weeks (18 ％),serum lipid levels after aspirin group were significantly reduced(P ＜ 0.05).Aspirin group before and after treatment,IMF,plaque area and lipid levels had no significant differences(P ＞ 0.05).Intensive lipid-lowering treatment group compared with the conventional dose group,IMT,plaque area and lipid levels improved obviously(P ＜ 0.05),the recurrence rate of ischemic cerebral vascular disease had significant difference compared with the other two groups (P ＜ 0.05).Conclusion Intensive lipid-lowering treatment on blood lipid levels,delay and reverse the carotid atherosclerosis is superior to conventional dose using fluvastatin group and simply antiplatelet group,and can prevent the recurrence of ischemic cerebrovascular disease.
